Monotherapy & combination therapy w/ sulfonylurea, metformin or insulin, adjunct to diet & exercise to improve glycemic control in patients w/ type 2 DM.
Monotherapy Initially 15 or 30 mg once daily. Max: 45 mg once daily. Combination therapy Initially 15 or 30 mg once daily w/ current sulphonylurea, metformin or insulin dose. Max: 45 mg once daily.
Do not use in patients w/ type 1 diabetes for the treatment of diabetic ketoacidosis. History of bladder cancer. Do not initiate in patients w/ active bladder cancer. Reduce dose in concomitant use w/ antidiabetic therapy (insulin or oral hypoglycemic agents). CHF, symptomatic heart failure, edema, macular edema. Closely monitor patient wt. Ovulation may occur in premenopausal anovulatory women; adequate contraception is recommended. Monitor liver enzymes prior to initiation & periodically thereafter. Patients w/ mildly elevated liver enzymes. Evaluate serum ALT levels prior to initiation of therapy & periodically thereafter. Discontinue therapy if jaundice is observed. Regular eye exam for diabetic patients. Increased incidence of bone fracture especially in women. Perform fasting plasma glucose & HbA1c measurements periodically. Caution in patients who experience visual disturbance when driving or using machines. Renal insufficiency. Pregnancy & lactation. Not recommended in childn <18 yr.
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